regarding reimburshment of private hospital in emergency cas

manjeet singh (Querist) 02 January 2013 This query is : Resolved
I am a central government employee.my father is purely dependent on me.15 days ago he was attacked by a sudden heart attack while he was returning after attending a merriage fuction with my cousin.he was taken to the nearby city private heart hospital by my cousin with the help of some strangers.he was admitted there in emergency condition and diagnosis as cardiovascular blockage and on same day he undergoes cardioplasty. Now I want to know that
1.whether his medical claims are reimbursable or not under CS(MA) rule 1944 or not.
2. What kind if documents are needed in this regard.
3is there any kind of honourable court's directions in such emergency cases treated in private hospital.

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Guest (Expert) 02 January 2013
Not a legal problem. So, you will have to go through CS(MA) Rules for knowing about the conditions prescribed for the treatment at the private hospitals in emergency cases.

Raj Kumar Makkad (Expert) 04 January 2013
You are entitled to claim reimbursement as per rules and so far as formality is concerned, take the help of clerek of your department.

manjeet singh (Querist) 05 January 2013
but they are apposing the claim by saying that the treatment was not done in government hospital and also not taking my reimbureshment application . is there any circular of health ministary or other relevent department in case of heart attack or in such emergency cases treatment done in private hospital.

Raj Kumar Makkad (Expert) 05 January 2013
This is established law that in the cases of acute emergency, a patient should take treatment from the nearest hospital irrespective of the fact it is govt or private hospital and whether this is is recognized (penal hospital) or not. Your case do come under this category.

Serve a legal notice and then file a civil suit.

Guest (Expert) 05 January 2013
Please buy one book on CSMA Rules and go in detail, as the book is filled up with a lot of Government of India decisions on various aspects. So, you will have to see for yourself which of the Government of India decision applies in your case.

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